Sept. 7, 2007 - A report released this week by the Centers for Disease Control and Prevention shows that suicide rates for 10- to 24-year-olds rose 8 percent between 2003 and 2004, the most recent year for which data exists. It's the largest uptick researchers have seen in 15 years, and it marks the end of a steady decline in suicide rates between 1990 and 2003. The steepest increases occurred among 10- to 14-year-old girls, whose suicide rate rose more than 75 percent, followed by 15- to 19-year-old girls and 15- to 19-year-old boys, whose rates rose 32 percent and 9 percent, respectively. (In absolute numbers, the rises were from 312 to 459 for the girls and from 1,222 to 1,345 for the boys.) As the report notes, because the data is based on death certificates, the actual number of deaths by suicide may exceed the 4,599 reported by coroners and other health officials in 2004. Dr. Keri Lubell, a behavior scientist in the CDC's Injury Center, and lead author of the new study, spoke to NEWSWEEK'S Tony Dokoupil. Excerpts:
NEWSWEEK: Are we facing a suicide epidemic?
Keri Lubell: We don't speak in terms of epidemics, but the trends that we see in this study are definitely of great concern to us. We looked at suicide rates for 10- to 24-year-olds over the period 1990-2004 and found that suicide rates had been declining up to 2003, but between 2003 and 2004 suicide rates rose by 8 percent, the greatest rise in the 15-year period. It's not really clear whether this is the beginning of a trend or merely a single year where something happened, so I wouldn't yet characterize it as a crisis. But it definitely calls for continuing to monitor these trends over time and trying to understand what's happening that might be underlying any changes in suicidal behavior.
What's important for parents to take away from these findings?
We want parents and teachers and others who work with youth to be aware of the warning signs of suicide—things like if a child or adolescent talks about killing themselves, talks about how things would be better if they weren't here, if they have sudden changes in sleeping or eating habits, or a sense of hopelessness about the future. These are things that should alert parents, teachers and others that they should talk to kids. They can ask directly if a youth is feeling suicidal, and then assess the situation and decide if the child needs to speak with a medical professional.
What's the next step for researchers hoping to explain the jump in suicide rates?
The first thing is continued monitoring of this trend. The second thing to concentrate on is learning more about the circumstances of suicidal behavior, particularly suicide death. For example, the CDC has a national violent-death reporting system—right now it covers only 17 states—but as that system expands we'll be able to know more about what's going on at the time of suicide. The other thing is that we really need more information about what really works to prevent suicide, especially among youth. It's of critical importance.
Other recent studies have found that youth suicide rates spiked in the same year that child and adolescent antidepressant use fell, leading some psychiatrists to conclude that the two trends are connected. What's your reaction?
Well, our study doesn't really speak to the antidepressant issue. But to the extent that antidepressants might or might not be playing a role, it's really important to keep in mind that suicide is a complex multidimensional issue, and when a suicide death occurs there's never any one single cause. Antidepressants or SSRIs might play a role in [suicides], but there are other things that we need to be aware of as well: family conflict, social isolation, and other things that factor into youths engaging in suicidal behavior.
It's interesting that the year of this spike in suicide rates is the same year that the Iraq war started. Could family members going off to war or returning changed from war impact youth suicide rates?
We haven't looked at what impact family members going off to war might have on youth suicide rates, so we wouldn't want to speculate beyond saying that it's something to be studied. While I can't speak specifically to the issue of family members going off to war, anything that affects families and family relationships is definitely potentially upsetting to children and potentially causing them difficulties.
There were also significant shifts in the most common methods of suicide, with firearms moving to number two and hanging and suffocation emerging as the most common method among girls.
Yes, and the magnitude of the increase is definitely a dramatic one. For 10- to14-year-old girls, the hanging/suffocation rate more than doubled—it rose by 119 percent [from 32 to 70 deaths]. And it rose by 44 percent among 15- to19-year-old girls. [In absolute numbers the rise was from 124 to 174 deaths.] That's a large shift for just one year, and it's also a concerning one. The issue with hanging and suffocation is that the means for hanging and suffocation are not easy to restrict access to. Other methods—firearms, poison, jumping from great heights—those are things that researchers and prevention folks have developed ways to restrict, but the means for hanging and suffocation are readily available. So, once again, it really says to us that we need to be looking at the broad reasons for suicide and focusing our prevention efforts there.
When can we expect the next year of data, and what will it mean?
The final data for 2005, which will be available late this year, will help researchers begin to know if these rates are short-lived or whether this is the beginning of a trend.
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